With delta variant on the rise, North Carolina moves to rehire more contact tracers
With the delta variant causing a weeks-long surge in cases of COVID-19, North Carolina is again “rapidly trying” to increase its number of contact tracers.
On Thursday, the state reported 5,900 new COVID-19 cases, and it was the 33rd consecutive day that the state has reported an increase in the number of people hospitalized, The News & Observer reported.
The surge comes after months of declining case loads and the nearing return of public schools and universities and large events, like concerts and football games.
Contact tracing is one of many tools that North Carolina is using to combat the coronavirus, using teams of tracers to reach out to individuals who may have come into contact with an infected person and asking them to isolate themselves.
“The more that people can know that they need to stay home while they may be infectious, the better off we’ll be,” said Erika Samoff, the contact tracing manager for the N.C. Department of Health and Human Services’ communicable disease branch.
At its peak, there were more than 2,400 contact tracers working in the state. But when cases began declining earlier this year, many left. Contact tracers are not directly employed by DHHS. A majority are employed by individual counties or third parties like Community Care of North Carolina.
Currently, there are 1,368 full- and part-time contact tracers working in North Carolina.
“It’s a complicated balance between trying to have enough staff to handle whatever comes at us, maintaining good experienced people ... but also being good custodians of the people’s money,” Samoff said of the declining number of contact tracers.
“We have tried to ride that cost-effectively. We definitely did decrease our staff as cases went down (and) we decreased it pretty significantly,” Samoff said. “We are now rapidly trying to increase it again. And that’s hard work, but we’re doing our best.”
Hard to keep up with the delta variant
Samoff said it’s been hard to logistically keep up with how contagious the delta variant has been. The delta variant is two to three times as contagious as the original virus, The News & Observer has reported.
“It’s really hard to hire fast enough to keep up with the case increases, especially this current one with delta moving so much faster,” she said.
Even with smaller numbers, the state has gotten much better at contacting potentially infected people, Samoff said. Last year, it was initially limited by having to reach individuals via phone calls, but it now has a number of potential communication avenues, like email or text message. It also has an online tool that allows infected people to voluntarily report their close contacts, rather than having to relay the information over the phone.
The contact tracing team could be further burdened by the reopening of schools and universities, especially if they aren’t requiring masks or vaccinations. Only 59 school districts, or 59% of the state’s 1.5 million public school students, are mandating mask usage in schools at the moment, The N&O reported. Those mask mandates are mainly being applied at schools in the state’s largest cities.
“Research shows that when kids in schools are masked, there’s very little transmission,” Samoff said. “And if we step outside of those boundaries and there’s more transmission, then that will be work that our contact tracers will have to do.”
With the return of college and professional football around the corner, Samoff said there is concern that the delta variant could lead to more infections at those events, which draw tens of thousands of fans.
But she noted outdoor events are much less risky than indoor ones.
“The protests from last year didn’t generate huge waves of cases,” she said. “That just reinforces that outdoors is safer than indoors.”
She said DHHS is still following the Centers of Disease Control and Prevention recommendation that defines “close contact” as being within six feet of an infected individual for 15 minutes or more. That makes tracking potential exposures more manageable, Samoff said.
Some scientists, however, are saying the delta variant is so contagious that it could take fewer than 15 minutes to infect someone, possibly just a minute if you are unvaccinated, The Wall Street Journal reported.
The delta variant is “primarily a risk to unvaccinated people,” Don Milton, a professor of environmental and occupational health at the University of Maryland School of Public Health, told The Wall Street Journal. “If you’re vaccinated, maybe 15 minutes or half an hour is what you need to get a big dose (of the coronavirus),” Milton added. “If you’re not vaccinated it will take hardly anything.”
NCDHHS still has its SlowCOVIDNC app for Android and iPhone
A change in the CDC guideline about “close contacts” would present a challenge to contact tracing, Samoff said, but we will “figure out how to manage it” if it does happen.
Contact tracing is important, Samoff added, but the state’s No. 1 tool to limit infections remains getting more North Carolinians vaccinated. Around 55% of North Carolinians 12 years or older are fully vaccinated, DHHS data shows.
“We need to get vaccinated, stay a little distant from each other, wear masks, (and) hang out outdoors,” she said. “It’s not rocket science at this point. We just need to trust information that has been proven over and over and over again.”
While not as important as in-person contact tracing, North Carolina is still using its COVID-19 exposure app, SlowCOVIDNC.
The app uses Bluetooth technology to track potential COVID-19 contacts. The app, available on Android and iPhones, shares random and anonymous IDs with nearby phones. If someone with the app has a positive COVID-19 test, they can enter a PIN into the app provided by a health department that will notify any other app user who was within six feet of them for 15 minutes or more.
Notifications will only tell users that they were exposed a certain number of days earlier, according to DHHS. Location data and names are not shared or stored.
As of Aug. 11, SlowCOVIDNC has been downloaded 898,412 times. Around 1,100 people have reported a positive COVID-19 case on the app, leading to 2,851 exposure notifications, DHHS said.
The app had been downloaded 100,000 times by last October, The N&O previously reported.
Samoff said the app “has not been adopted by a very high proportion of the same population,” but it remains useful for certain situations.
For tight groups, like a daycare pool or a dormitory, she said, it could be a really functional tool if everyone has downloaded it.
“We’re happy to have it to be able to offer that tool to the people that that’s the right tool for,” she said. “...There are situations where even though it’s not being used by everybody, it can still be functional for a tight group.”
This story was produced with financial support from a coalition of partners led by Innovate Raleigh as part of an independent journalism fellowship program. The N&O maintains full editorial control of the work. Learn more; go to bit.ly/newsinnovate
This story was originally published August 13, 2021 at 8:00 AM.